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Writer's pictureLucy Frew Naturopath

Menopause Starts In Your 40's: Perimenopause!

I love this North American Indian saying:

“ At menarche you meet your wisdom; with monthly bleeding you practice your wisdom; and, at menopause, you become your wisdom”



And for all those women out there "becoming your wisdom" may not be an easy path! I find most women don't realize that they are in Perimenopause in their 40th decade. There are so many different symptoms happening and more importantly, there is a lot you can do to ease your transition and help with your symptoms.


Perimenopause is the 2 – 12 years before the onset of Menopause. It is typically the 40th Decade. This is the period of time of the most symptoms due to hormonal fluctuations.

True Menopause is the stage you reach when twelve months have gone by without having a period. And interestingly it is a period that is usually a lot more stable as far as all the physical and emotional symptoms go.


Why is Perimenopause the time of most symptoms?


As we hit the perimenopausal years, progesterone is dropping away and Estrogen is either going up or fluctuating wildly. In fact, Estrogen can be up to 3 x higher than normal.

We lose only 80 – 90% of our estrogen but we lose all of our progesterone!

Through our normal cycle we make 100 x more progesterone than estrogen and this happens each month from mid cycle onward, after we ovulate.

The period of Peri-menopause is usually marked by lower than normal progesterone and high or fluctuating oestrogens. And it is this Relative Estrogen Dominance that is the culprit of a whole lot of problems.

Generally Relative Estrogen Dominance puts you in a pro-growth situation and so you see things like thickened endometrium, fibroids, breast distention and breast cysts, weight gain, fatigue and mood changes.

Also, something that is little known is that Perimenopause can result in a relative testosterone dominance which can give you symptoms such as:


· Thickened waist and more square shape body

· Insulin resistance

· Irritability – angry with a short fuse and intolerance

· Different body odour.


Menopause / Perimenopause can be spread over 4 stages:

Phase 1 – symptoms emerging but still having regular periods. PMS might be getting a bit worse, some hot flushes may be starting. This is PeriMenopause and this can start as early as 38 yrs.

Phase 2– Periods starting to vary by more than 7 days. Progesterone is starting to decrease. Symptoms can start to get worse.

Phase 3 – Periods start to vary by more than a month. Symptoms may become stronger

Phase 4 – This is the WAITING ROOM – the period of time between the last bleed and the 12 month mark passing when oestrogen is mostly low . Then once the period has stopped for 12 months you are considered post menopausal.



PERIMENOPAUSE SYMPTOM CHECK LIST

There is no outright test for Perimenopause . You can use FSH levels as a guide. There is however a general symptom picture.

If you have any 3 of the following 9 changes you are considered in Perimenopause.


1. New onset of heavy and/or longer flow


2. Shortened menstrual cycle – like under 26 days. Usually, an indication that oestrogen is getting higher. FSH (follicle Stimulating Hormone) is getting higher as the body attempts to trigger ovulation.


3. New sore, lumpy or swollen breasts


4. New mid sleep waking


5. Increased menstrual cramps


6. Onset of night sweats in particularly pre-menstrually


7. New or marked increase in migraine headaches


8. New or increased pre-menstrual mood swings


9. Weight gain without changes in exercise or eating


If you do get your doctor to test your FSH levels:

A “normal” FSH on day 3 (when the test is administered) is a value of 3-20 IU/ml, however, FSH levels above 10 to 12 IU/ml indicate that your ovaries are starting to fail.

In other words, this means that you are in perimenopause— the beginning stages of menopause when you notice physical symptoms, but before you have stopped having a period for a year.

Higher FSH levels — levels of about 30 to 40 or above — are usually taken to signal menopause. You may still even be getting periods with your FSH levels this high, but it still is a sign that your body isn’t producing enough estrogen to maintain regular ovarian function.


The good news is that I can help you navigate this turbulent time. There is so many extraordinary herbal medicines that can help balance your hormones. It's my favorite area to work with as I love helping women feel better, get control of their health and be the best that they can be!


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